At a glance: Haiti

Pursuing universal salt iodization in Haiti

At the FONDEFH clinic in Camp Aviation, Haiti, Marlene Nelson and her daughter, Erica, receive iodized salt. Insufficient iodine during the prenatal period and the first few years of life can result in irreversible brain damage.

By Suzanne Suh

PORT-AU-PRINCE, Haiti, 21 September 2012 - From the outside, the clinic does not look like a health clinic at all. It is one of many modest buildings huddled together under the blazing sun, surrounded by a sea of tents. But inside, the clinic bustles with activity. Women queue to receive food, pregnant women sit waiting patiently on folded chairs, and, everywhere, babies squirm, bawl and slumber in their mothers’ arms.

This clinic, operated by local NGO Fondation pour le Développement et l'Encadrement de la Famille Haïtienne (FONDEFH) and supported by UNICEF, treats malnourished children and provides fortified foods to mothers.

Delva Judith has come to the FONDEFH clinic today. Ms. Judith is five months pregnant with her third child. She comes to the clinic every day to get the fortified foods that will protect her growing baby – especially iodized salt.

“I come to the clinic every day,” she says. “They told me it is important for me to use salt that is iodized. Before, I didn’t know how important it was.”

Iodine, iodized salt and iodine deficiency

Iodized salt is table salt mixed with iodine. The ingestion of iodine prevents iodine deficiency disorders (IDDs). Worldwide, iodine deficiency affects about two billion people and is the leading preventable cause of mental retardation.

Wislene Poliscard receives iodized salt at the FONDEFH clinic. “I learned that, if you don’t use iodized salt, you can get gro kou [goiter],” she says.

In fact, insufficient iodine during the prenatal period and the first few years of life can result in irreversible brain damage.

“Unless the deficiency is corrected before brain development is completed, iodine-deficient children will be poorly equipped to fight disease and to learn, and will become adults who are unable to work effectively,” says UNICEF Nutrition Specialist Ismael Ngnie Teta. He adds, “Promoting the universal production and consumption of iodized salt is the easiest and most cost-effective means to prevent, control and eliminate IDD.”

High levels of iodine deficiency

Only 3 per cent of households in Haiti have access to iodized salt, whereas the global average is about 70 per cent. Although Haiti remains one of 54 countries in the world that still have significant iodine deficiency problems, the country has no government legislation for salt iodization.

A 2008 study conducted in a mountainous part of Haiti showed that 93 per cent of the participants exhibited some iodine deficiency, and 20 per cent showed severe deficiency.

Anne-Rose St. Preux, who is responsible for the Nutrition Programme at the FONDEFH clinic, explains, “The problem is that iodized salt is more expensive and harder to find. And with the regular salt, you have to wash a lot of dirt out of the salt, and that, in turn, washes out a lot of the iodine.”

Salt plant provides support

UNICEF is supporting a salt plant managed by the University of Notre Dame and the Haitian Ministry of Public Health and Population. This partnership aims at providing iodized salt to 600,000 people in five departments.

Delva Judith cooks with iodized salt outside her home in Camp Aviation. Iodized salt is a rare commodity in Haiti, and the country has a significant iodine deficiency problem.

Director of the University of Notre Dame in Haiti Jean Marc Brissau explains that the programme does not end with production: “We are targeting communities for distributions, but also for behaviour change. We promote consumption of iodized salt, and we use a sound truck playing a jingle in markets and bus stops.”

Partners strengthen support

UNICEF is also working closely with the Ministry of Public Health and Population and partners such as FONDEFH and the World Food Programme to reduce IDD in Haiti, through distribution of fortified foods and by advocating for an increase in commitment to universal salt iodization by the government and its partners.

Ms. St. Preux points out, “Since the earthquake, I have seen the number of women who use iodized salt go up. In fact, we never have enough for all the women who come here – we always run out.”

But it remains difficult to ensure sustainable political commitment for IDD elimination and action.

Raphy Favre works for the First Lady’s Office, which leads the Aba Grangou (“Down with Hunger”) movement to end hunger and malnutrition in Haiti. He believes that there is hope on the horizon. “We are pushing for the fortification of salt,” he reports. “We have already drafted legislation to regulate fortified salt, flour and oil.” The law is currently being reviewed by the Prime Minister’s Office.

For too many women and children, universal iodization of salt has come too late. But, with increasing government commitment and support from partners such as UNICEF, no child in Haiti should be deprived of the most basic, yet most essential, nutrients.